Abstract

A total of 558 farmers were interviewed in the counties of
Kakamega and Machakos in Kenya during 2007–08 regarding their attitudes and
practices relating to livestock diseases
and their recognition and management. Most respondents regarded East Coast
fever (ECF), contagious caprine pleuropneumonia (CCPP) and Newcastle Disease
(ND) as the most important diseases of cattle, small ruminants and chickens,
respectively. There was a high degree of awareness and past use of
vaccines and treatments for a number of cattle diseases and these activities
were most likely to be carried out by a veterinarian. There was less use
of vaccines in small ruminants and chickens but disease treatments were commonly
used. Poultry vaccines were purchased from veterinarians and from agrovet
shops. Less than half the respondents believed vaccines to be effective
but few reported suspected ineffective vaccinations to a veterinary officer.
Most respondents (Kakamega only) were willing to pay up to 5Ksh, 10Ksh and 20Ksh
for chicken, small ruminant and cattle vaccines, respectively. Respondents
preferred the administration of poultry vaccines to be via drinking water and
most preferred vaccination on an individual farm basis rather than group
vaccination activities. Almost all the respondents expressed the need for
training in poultry vaccination. Respondents expressed a preference for
vaccine pack sizes of less than 50 doses and for the availability of
thermo-tolerant vaccines.

Introduction

Livestock production is critical in supporting the livelihoods of poor farmers
throughout the developing world (McDermott et al 1999, FAO 2002; Perry and Sones
2007). For example in Kenya, livestock production is estimated to
contribute approximately 12% to GDP (FAO, 2005). Animal disease and
veterinary public-health problems constitute a major constraint to livestock
production and safe utilization of animal products worldwide (FAO 2002; Domenech
et al 2006). Large sums of money have been invested by governments,
non-governmental organizations (NGOs) and other donors into research and methods
of control of livestock disease, however, there are still major gaps in our
ability to control a large number of these diseases (Perry and Grace 2009).
It is generally recognised that there is a lack of availability of and access to
veterinary medicines and vaccines in many developing countries, largely because
the US and European based animal health industries do not believe there is
adequate potential for return on investment (Anon 2006) and that this is often
due to lack of supply chains at the local level (Delgado and Narrod 2002).

The Global Alliance for Livestock Veterinary Medicines (GALVmed;
www.galvmed.org)
was established in 2004 as a not-for-profit organisation to develop veterinary
medicines for livestock where the market is too small or fragmented for the
western animal health industry to invest. GALVmed initially prioritised
livestock diseases in developing countries depending on perceived unmet need,
irrespective of species.

In order to make strategic decisions it was important for GALVmed to understand
better the identity, attitudes and needs of the potential end users of
veterinary medicines i.e., the village farmer. It is well documented that
small-scale farming tends to be mixed in terms of both crops and livestock.
Thus, the target diseases for GALVmed include those of poultry, small ruminants
and cattle. Whilst information is available on the identity and causes of
livestock disease in these communities (e.g. Domenech et al 2006), less is known
about the farmers’ attitudes to them and their willingness to use veterinary
medicines if they are available.

For example, Newcastle Disease (ND) is the most prevalent and fatal disease of
poultry in Kenya (Kingori et al 2010) and thus a major key unmet need initially
identified by GALVmed was for a sustainable supply of thermo-tolerant ND
vaccine. Although such vaccines have been in use in a number of countries
(Bensink and Spradbrow 1999) there is a continuing need for standardization and
sustained production together with sustained delivery to Sector 4 (Village or
Backyard) production, as defined by FAO (2007) and ILRI (2007). Similarly,
information is also lacking on production practice, constraints and diseases, of
other species in this sector.

Therefore, the overall objective of this study was to characterize the status of
smallholder livestock production systems in Kenya, in order to generate
information to assist in the design and targeting of veterinary medicines for
rural livestock keepers. Whilst the first paper (Peters et al 2012)
focused on the demographics and the contribution of
different crops and livestock towards household income this paper
concentrates on disease recognition and management.

Materials and methods

Two counties in different regions of Kenya were selected for the project.
Firstly, Kakamega is in western Kenya lying about 30 km north of the Equator. It
is the provincial headquarters of Western Province. It had a population of
73,607 (1999 census) and is 52 km north of Kisumu which is the third largest
city in Kenya. Secondly, the town of Machakos is 64 km southeast of Nairobi. It
is the capital of the county of Machakos in Eastern Province of Kenya.
Machakos is a major rural centre, and also a satellite town, due to its
proximity, to Nairobi. Its population is rapidly growing and was 192,117
in 2009. Machakos has a number of financial institutions, administrative
offices, good road infrastructure and town planning. These two counties
were selected to represent different socio-economic areas of Kenya, Kakamega
county representing medium to high potential areas, while Machakos represents
arid and semi-arid areas. Kakamega is more densely populated than Machakos,
while Machakos has larger farms. The crops produced are similar but
Machakos has drought tolerant varieties compared to Kakamega. The two counties
together represent the major ecological zones of Kenya.

This study was conducted on behalf of GALVmed by Biotechnology Africa (BTA) in
collaboration with the Ministry of Livestock Development and Fisheries and the
Ministry of Agriculture between
December 2007 and April 2008. Background
preparation included ethical approval for the project, meeting with the
stakeholders, discussing the study logistics and general planning. This
included training researchers on questionnaire administration at research sites
and also involving community heads and local guides. The field work began
with communication and advocacy meetings conducted with the assistance of the
provincial administration. It was followed by face to face interviews with
a cross section of respondents in the farming community.

Results

The respondents’ perceptions of the most important livestock diseases are shown
in Table 1. For cattle, approximately 60% reported East Coast fever (ECF)
to be the most important disease with anaplasmosis, FMD, contagious bovine
pleuropneumonia (CBPP), black quarter and gastro-intestinal parasites also being
regarded as important. For small ruminants, contagious caprine
pleuropneumonia (CCPP) was reported as the most important by 64–73% of
respondents, with anaplasmosis also being reported as important. For
poultry, Newcastle Disease (ND) was reported by around 95% of respondents as
being most important with coccidiosis, fowl pox and fowl typhoid also being
regarded as important.

Table 1. Farmers’ perception of the most important livestock
diseases

Characteristics

Kakamega

Machakos

Total number of respondents

313 (56%)

245 (44%)

Percentage of respondents

Farmers’ perception of the most important single disease
in cattle

East Coast fever (ECF)

56.7

66.3

Farmers’ perception of the most important single disease
in small ruminants

Contagious caprine pleuropneumonia (CCPP)

73.3

63.8

Farmers’ perception of the most important single disease
in chicken

Newcastle Disease (ND)

95.8

94.5

Aspects of the management of cattle disease by respondent farmers are shown in
Table 2. According to Table 2, most farmers used vaccines and treatments
for cattle disease. Vaccines were used against several cattle diseases but
only by a minority of farmers for each specific disease. A number of
diseases were treated as they occurred, including ECF, anaplasmosis and
parasites. Cattle vaccination was largely carried out by veterinarians as
they tended to be organised by the government and compulsory when disease
outbreaks occurred. Cattle treatments for disease were mostly administered
by veterinarians or by para-veterinarians.

Table 2. Vaccination and treatment of cattle

Activity

Percentage of respondents

Kakamega

Machakos

Farmers use of:

Vaccines to prevent diseases in cattle

67.0

69.0

Treatments for diseases in cattle

74.0

79.0

Farmers who have vaccinated against:

ECF

28.1

13.4

Blackquarter

17.5

10.0

Foot and mouth disease

7.5

12.4

Lumpy skin disease

6.2

8.6

Rift Valley fever

5.5

5.3

Anthrax

4.8

20.1

Farmers who have treated for these diseases:

ECF

10.0

27.4

Anaplasmosis

33.1

29.8

Parasites

31.9

23.3

Persons vaccinating cattle against disease

Veterinarian

72.0

86.0

Persons treating cattle for disease

Veterinarian

53.0

70.0

Para-veterinarian

15.0

4.0

Aspects of the management of small ruminant disease by respondent farmers are
shown in Table 3, which shows that less than half of the farmers used vaccines
for small ruminants. CCPP was the most common vaccine used reflecting its
perceived status as the most important small ruminant disease. Most
farmers used treatments for small ruminant disease and parasite infestation was
the most common reason for treatment. Vaccination was commonly carried out
by veterinarians; this was especially marked in Machakos. Disease
treatments for small ruminants were administered by veterinarians and by para-veterinarians
but also about 1/4 were given by the farmers.

Table 3. Vaccination and treatment of small ruminants

Activity

Percentage of respondents

Kakamega

Machakos

Farmers’ use of:

Vaccines to prevent disease in small ruminants

23.0

46.0

Treatments for disease in small ruminants

72.0

91.0

Farmers who have vaccinated against:

CCPP

24.0

51.0

Farmers who have treated for these diseases:

CCPP

13.0

15.0

Parasites

37.0

39.0

Respiratory disease

2.0

11.0

Persons vaccinating small ruminants against disease

Veterinarian

41.0

80.0

Persons treating small ruminants for disease

Farmer

24.0

20.0

Veterinarian

33.0

63.0

Para-veterinarian

14.0

5.0

Activities related to the management of poultry disease are shown in Table 4.
Both regions actively treated their poultry for diseases (64–84%) but few
carried out vaccinations (18–39%). Where farmers did vaccinate they obtained
the vaccines mainly from veterinarians or from Agrovet shops. The majority of drugs for treatment of livestock were obtained from
Agrovet shops (45–54%). Where vaccines were used, about 25% farmers vaccinated
their own poultry, with others having the services of veterinarians and paravets.
A small proportion (reportedly in Machakos only) vaccinated on a farmer-group
basis. A much larger proportion (64–72%) of farmers carried out their own
disease treatments in poultry.

Table 4. Vaccination and treatment of poultry

Activity

Percentage of respondents

Kakamega

Machakos

Farmers’ use of:

Vaccines to prevent disease in chickens

39.3

17.5

Treatment for disease in chickens

63.5

84.2

Source of vaccine for those using vaccinations

Veterinarians

27.3

4.6

Agrovet shops

9.5

11.2

Source of treatments for disease

Agrovet shops

44.5

54.1

Persons vaccinating poultry

Farmer

26.5

25.6

Veterinarian

14.6

24.4

Paravet

37.1

6.7

Person treating poultry

Farmer

63.9

71.6

Veterinarian

7.8

13.5

Paravet

3.5

2.4

Responses to questions concerning vaccination and treatment of disease indicated
a general awareness of the services offered by veterinarians and paravets.
However, there was specific interest in the awareness of local Agrovet shops and
the products and services available. The survey showed that there was a
high level of awareness of Agrovet shops (Kakamega 78% and Machakos 71%) and
that they sold products such as veterinary drugs, vaccines, fertilizers and
feeds (Kakamega 87% and Machakos 83%).

Respondents were asked about their perception of general effectiveness of
vaccination (Table 5). Only 40% in Kakamega and 25% in Machakos perceived
vaccination to be effective. About 7–8% claimed to report perceived vaccination
failure to local veterinary officers. Respondents were also asked about
their willingness to pay for vaccines for the various species and the results
are shown in Table 5. Generally, the vast majority of respondents were
willing to pay up to 5Ksh, 10Ksh and 20Ksh for poultry, small ruminant and
cattle vaccines, respectively.

Table 5. Vaccination effectiveness and cost

Activity

Percentage of respondents

Kakamega

Machakos

Respondents perceiving vaccination to be effective

40.2

25.0

Ineffective vaccines reported to vet officer

7.8

7.1

Amount respondents willing to pay for vaccine (Ksh)

Poultry ≤5

100.0

ND

Small ruminants ≤10

100.0

ND

Cattle ≤20

94.9

ND

ND = No data

Questions were asked concerning the administration of poultry vaccines and the
results are shown in Table 6. Most respondents regarded vaccination as
being simple or only moderately difficult. Very few regarded it as
complicated. By far the most common method of administration was via the
drinking water (67–71%) and 18–25% by eye or nasal drop. About 33% of the
respondents vaccinated their poultry on a group basis with neighbours whilst
about 60% typically carried out vaccination on an individual basis. There
was an overwhelming need for training in vaccination and many respondents felt
there was a need for training in various aspects of poultry husbandry including
management and feeding. Few respondents felt the need for training in
recognition of disease symptoms.

Table 6. Administration of vaccines to poultry

Activity

Percentage of respondents

Kakamega

Machakos

Ease of vaccination

Simple

24.2

10.7

Moderately difficult

26.8

28.3

Complicated

1.3

5.3

Administration of poultry vaccine

Drop in eye or nostrils

25.4

17.7

In drinking water

66.9

70.7

In food

7.7

8.6

Group vaccination

Yes

33.4

33.2

No

61.3

59.1

Preference for Group or Individual vaccination

Prefer Group vaccination

37.0

43.0

Prefer Individual vaccination

63.0

57.0

A need for training in chicken vaccination

Yes

98.3

99.6

No

1.7

0.4

A need for training in poultry husbandry

Feeding and nutrition

50.2

53.0

Management

14.8

8.6

Disease symptoms and diagnosis

2.0

1.3

For improved independence of farmer

37.1

33.1

Some responses regarding vaccine formulation and packaging are summarised in
Table 7. Packaging preference was for the vaccine to be in plastic
container bottles with 50 doses being the maximum preferred package for optimum
economy and affordability. By far the greatest preference for the
characteristics of a vaccine is that it is supplied in liquid, thermo-tolerant
form, compared to other available formulations.

Table 7. Vaccine formulation and packaging

Vaccine characteristic

Percentage of respondents

Kakamega

Machakos

Preference for plastic packaging

54.2

27.3

Preferred pack size ≤50 doses

90.0

82.8

Preferred formulation:

Liquid thermo-tolerant

80.1

61.6

Discussion

As GALVmed is a relatively new organisation just entering the animal health
sector, it was considered appropriate to collect information from potential end
users as to the kind of prevalent livestock production systems, their production
and marketing activities, and their attitudes and practices relating to disease
diagnosis, treatment and control.

The respondents identified ECF as the most important disease constraining cattle
production. East Coast Fever is a tick borne disease of the lymphatic
system caused by the protozoan parasite Theileria parva. It is
endemic in 11 countries in eastern, central and southern Africa, where over 40
million cattle are considered at risk (Norval et al 1992; Dolan 1999; Minjauw
and McLeod 2003). Mortality rate can be as high as 90% depending on
susceptibility. East Coast Fever has been controlled largely by vector
control, using acaricide dips and sprays since the early 1900’s and the
chemotherapeutic treatment parvaquone and buparvaquone became available in the
1980s (Muraguri et al 1998). A vaccine was developed in the 1970’s (Radley
et al 1975a, b, c) whereby a cocktail of field strains (the Muguga cocktail) of
the parasite was administered to cattle simultaneously with antibiotic
treatment. This became known as the Infection and Treatment Method (ITM) and has
not yet been superseded by a conventional or molecular based vaccine. Due
to its narrow margin of safety the use of this vaccine has been controversial
and until recently had not been widely disseminated or indeed registered in any
country. However, because of the lack of a suitable alternative, GALVmed
and its partners have sponsored further production of Muguga cocktail, transfer
to commercial manufacture, registration and distribution in target countries,
including Kenya, Tanzania and Malawi (Peters 2009). Other monovalent
variants of ITM e.g. Marekebuni, have also been available in Kenya over the
years.

A small proportion of farmers (13–28%) responded that had vaccinated against ECF,
a percentage probably consistent with limited and variable availability of ITM
vaccines. Farmers also used vaccines against blackquarter, a lethal
clostridial disease, foot and mouth disease (FMD), LSD, a pox virus related to
the capripox virus of small ruminants, Rift Valley fever and anthrax. Rift
Valley fever and LSD have been targeted by GALVmed as priority diseases for
improved vaccine development.

Contagious caprine pleuropneumonia was identified by farmers as the most
important disease in small ruminants. Contagious caprine pleuropneumonia is a
severe respiratory and systemic disease of sheep and goats caused by
Mycoplasma mycoides
subsp. Capripneumoniae (Thiaucourt and Bölske 1996).
Vaccines are available on a limited scale and treatment is possible with
antibiotics, although expensive. It is generally accepted that the wider
availability of effective vaccines would be advantageous. Parasitic
disease both internal and external are known to be one of the major constraints
to livestock production worldwide and a wide range of anti-parasitic agents have
been available for many decades. To date the focus of international
development in animal health and the GALVmed strategy have tended to focus on
‘neglected’ and transboundary diseases, but it is important to remember that
many of the endemic diseases affecting livestock production in the developed
world are also important in the developing world.

Overall from the survey it appears that the person most likely to vaccinate
cattle and small ruminants is a veterinarian. It was not specified whether
this service was private or government based, but in all probability this was
most likely to be the latter. However, Cheneau et al (2004) recently
reviewed the provision of veterinary services in the developing world. They
suggest that state veterinary services have declined since the 1970s due to a
growth in privatisation (Chilonda and Huylenbroeck 2001) which has to some
extent improved the delivery of veterinary services but this has been limited
and Cheneau et al (2004) inferred that the potential for public provision of
veterinary services has been underrated. Utilisation of the services of
para-veterinarians, technicians trained in specific aspects of livestock disease
diagnosis and treatment has assumed considerable importance in developing
countries (Catley et al 2004). There has been considerable resource put
into the development of community animal health worker (CAHW) systems and there
is evidence that these have had a significant impact on animal health in many
areas (Catley et al 2004). It is clear that these so-called para-professional
classes of veterinary support such as para-veterinarians and community animal
health workers have expanded in recent years to fill the gap in veterinary
services in the more remote pastoral areas (Cheneau et al 2004).

Farmers’ perception of the single most important disease of poultry was
Newcastle Disease (ND).
ND is a severe and highly contagious disease of poultry (Alexander 2001) and is
regarded as second in impact only to avian influenza. In countries where
the disease is endemic, vaccines are used to a greater or lesser extent.
Whilst vaccination is considered effective, there are practical issues of
vaccine delivery to remote rural areas and the major need is for a
thermo-tolerant vaccine formulation (Bensink and Spradbrow 1999) i.e. one that
is stable in ambient temperatures and thus does not require refrigeration and
this opinion was supported in the present study. Whilst thermo-tolerant
vaccines are available their production and use are sporadic and a major GALVmed
priority is to improve the quality and reliability of supply of such vaccines.
Nevertheless the I-2 vaccine (Bensink and Spradbrow 1999) has been used
extensively in a number of countries including Mozambique and has had a
significant positive impact on numbers of chickens produced (Bagnol 2001).
Respondents expressed a preference for administration of vaccine to chickens via
the drinking water similar to the results of a study carried out in South Africa
(Thekisoe et al 2004) using the Nobilis® ND Inkukhu vaccine. The three routes of
administration viz. eye drop, drinking water or feed, and the eye drop and drinking
water routes were shown to be equally effective.

Given the lower monetary value it is to be expected that there was less
veterinary involvement in treatment and vaccination of chickens compared to
ruminants. Almost 100% of respondents expressed interest in training in
chicken vaccination. Furthermore, approximately half of respondents
expressed interest in training in feeding and nutrition of poultry.

The respondents expressed a preference for pack sizes of no more than 50
doses for ND vaccines. Pack size has a direct impact on price with smaller
pack sizes being more costly per dose. Given the preference for smaller
pack sizes it was surprising that around 60% of respondents preferred
vaccinating individually rather than on a farmer-group basis. The reason for
vaccinating individually was not evident in the present study.

In both locations, there was a high degree of awareness and usage (approximately
50%) of Agrovet shops for the purchase of animal medicines. Turkson (2009)
recently carried out a similar type of survey in Ghana looking at the relative
availability of veterinary medicines and care in different locations and found
that regional differences were insufficient to recommend location specific
delivery systems.

In summary, the present study has revealed insights into local attitudes and
practices relating to animal husbandry and diseases which will be of benefit to
organisations such as GALVmed in designing veterinary medicines which are
focused on the preferences and needs of small rural livestock keepers in Kenya
and similar countries.

Acknowledgements

We are grateful to Dr Rubina Sharrif for assistance with this project. The
generous funding of the UK Department for International Development and the Bill
and Melinda Gates Foundation is gratefully acknowledged.

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